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Ugh! Thrush - how to treat if I'm not sure I have it?

We took DD to the pedi last night b/c she had some little white spots in her mouth & it turned out to be a little bit of thrush Kinda bummed - we treated "thrush" for about 3mos last fall (turned out to be vasospasms caused by my pump) - so I'm less than excited to be dealing with it again. The difference this time though is that DD actually has it (don't think she ever did before, still not sure if I did or not). Anywho, she's on Nystatin now & I'm sneaking some probiotic powder into her food here and there. I'm not sure if I have it or not, so I'm not really sure how drastic I need to be about treating myself...

I have been having nipple pain for the last few weeks, which I think is mostly due to DD not latching well & wiggling/pulling a lot (she's teething). It does not hurt to nurse if she's latched well. My nips are always a little sore & pinkish b/c they get irritated by my pump, so it's hard to tell if there's been any change there. The soreness wasn't getting worse & I don't have any shooting pains, so I was pretty sure I didn't have thrush (until we found out that DD has it). Now not so sure. I am a little itchy, off and on, which started the morning that we saw the spots in her mouth - power of suggestion maybe?

My question is - how drastic do I need to be in treating myself? I've been applying some APNO (Newman's) which I had leftover from the fall. Doing this sparingly though as it turned out to be irritating me more than it was helping (after using it for 3mos straight). Also been putting some probiotic powder (crushed up pills) on my nips after nursing/pumping. And taking probiotics orally, 2 pills per day. Can't eat yogurt b/c DD is dairy intolerant. I REALLY don't want to dump my milk...I have plenty stored but I hate to dump it if I'm not even really sure that I have yeast. I don't have any shooting, deep pains in my breasts so I am quite confident that my milk ducts aren't infected, even if my nipples are a little bit. Do I really need to dump? We scald anything that will be frozen due to lipase...not sure if that matters or not. Also, is it really necessary to boil/steam ALL the pump parts & bottles if my milk ducts aren't infected? Obviously we are doing DD's paci's and bottle nipples, but I don't know if we need to be boiling all the bottles and stuff. Our water leaves a gross film on everything we boil, so I'm trying to avoid repetitive boiling if we can...

Anyone have any advice? I definitely want to beat this, just don't want to waste time & milk if I don't have to. Thanks!

Re: Ugh! Thrush - how to treat if I'm not sure I have it?

Also, a study showed that oral fluconazole is more effective than oral nystatin in both mother and baby if you are going the oral prescription route. It showed Nystatin effective about 30% of the time while fluconazole 100%. But Newman says other treatments shoudl be tried prior to oral fluconazole for mother. I am not sure about what he would reccomend for baby. Since you are already doing nystatin for baby, I guess you could keep with that and see if it works.

Re: Ugh! Thrush - how to treat if I'm not sure I have it?

Thank you for responding! Meg, thank you for the links, they were really helpful! I'll be referring back to those for sure if we don't clear it up with this first try...

Things have improved, DD's tiny spot is gone now so the Nystatin seems to have worked. The doc that we saw said that we could stop using it when it cleared up but this is not what I've heard from others so I think we'll finish the prescription. I'm feeling about the same, maybe a little better. It's really hard for me to tell b/c my nipples are almost always sore & a little red/pink (off and on, they change color it seems) b/c they are irritated by my pump (vasospasms). I have been using the Newman's cream probably 4-5x a day (not after every single feeding, but most) w/the probiotic powder and taking probiotics orally 2 per day. I don't have any shooting pains at all, just some nipple soreness off and on. Nursing is about the same, feels fine as long as DD is latched well. A bit sore/sandpapery if she's really wiggling or pulling.

We have been using the Medela steam bags to sterilize her bottle nipples, pacis and medicine droppers, also my pump parts. I talked to my IBCLC the other day and she said it was fine to freeze what I pump while we're treating. She also said we don't need to sterilize everything, just treat it, get the yeast back in balance & move on. I've been keeping track of the toys that she's put in her mouth and plan to machine wash what I can. What would you ladies recommend for cleaning the stuff that can't be machine washed? I'll do warm soapy water for what I can, but some things say to not even submerge in water - would lysol or clorox wipes be ok to use for that stuff? Maybe just don't give it back to her for a day or so?

Thanks again for the replies - what a pain this is!

ETA: The IBCLC told me about an ointment that Mother Love makes for diaper rash/thrush - it's all natural so it wouldn't (I'm assuming) be as irritating as the Newman's. Has anyone used it on their nipples for thrush? I'm thinking about getting it b/c I love their regular cream, just wondering what others' experiences are with it. Thanks!